eHealth Exchange

20th Nov 2002

Personal review by Rod Ward

This event was organised by Enterprise Events "Partnerships in
Healthcare" and was intended as avenue for interested parties to meet and
discuss current issues rather than a traditional conference. Delegates had
registered before the event and selected the sessions, discussion groups and
individual meetings they wished to attend, which had been then been prepared
for them into a personal agenda, which was available in advance on-line and was
included in the delegate pack from the reception desk. This process seemed to
work well. The venue at the Queen Elizabeth II Conference Centre, London was easy to get
to and provided continuous coffee :-)

Individual meetings and discussion groups, of around 8 people, were
organised onto numbered tables, which the correct supporting papers made
available by the staff. Some groups leaders seemed much more comfortable with
running small group discussions than others. The better ones acting as
facilitators encouraging people to introduce themselves and encouraging
everyone to have their say. Others either wanted to give an exposition on their
pet topic, or just repeated their original questions when the group
"strayed" into other areas - which were sometimes more interesting
than the original question.

The first discussion group I attended was led by George Davies,
National project Manager (ECDL), NHS Information Authority who led a discussion
about Basic IT skills in the NHS - Using the ECDL

The table included elearning suppliers and project leaders & IT trainers
from NHS trusts. George briefly set out the history, current situation and
future developments in this area with some figures for uptake so far (8000
studying & 3500 completed), and data from a small scale evaluation which
showed a saving of 38 mins per person per day after completing ECDL. He gave
several examples of how this project differed from other NHS/DoH projects
saying "this is an investment in people rather than things".
Discussion centered around ways of motivating staff and encouraging them, costs
and benefits of elearning for this (being delivered by
Spring IT
training) and how to work with the approx. 25% of NHS staff with absolutely
0 IT skills. George also mentioned the forthcoming voucher scheme available to
all NHS staff so that neither individual staff or trusts would have to pay for
the on-line materials - although attendance at a test centre to complete the
assessments would still be required.

I then had an individual meeting with a project manager from
Surrey Ambulance Service who is
currently undertaking her
MSc in
Health Informatics at the University of
Sheffield we discussed ways in which her course could be related to her
practice area and the potential of ICT systems in that area of practice. She
also helped me in looking at the information and educational needs of ambulance
staff. We overran our allotted meeting time and agreed to continue the
discussion by email.

The next group discussion I attended was led by Peter Jones Team
Leader, Community Mental Health Services for Older People, Chorley, Lancs and
addressed "Finding an Information Space for the Multidisciplinary
Team!".

His opening remarks set out Hodges' Health Career Model, which led to
discussions about the evidence base and the importance of the
single assessment process (SAP)
& Care Programme Approach (CPA) , and the differing views of patient data
required at different times by different professionals with varied roles. An
example was given of a project to enable A&E staff to check children on the
"At Risk Register" in a safe manner & with up to date
information.

Worries were expressed about the profusion of data sets and care episodes.

The 3rd group session I attended considered Development and Change of
existing staff skills across boundaries, which was led by Jan Harry,
Director of Nursing & Quality Assurance,
Mid Staffordshire General Hospitals NHS
Trust.

Jan highlighted changes in the need for skills amongst the NHS workforce and
changes in professional boundaries involved in workforce planning and capacity
planning. The discussion touched on the roles of Workforce Development
Confederations and the relationship between their work and care pathways.

My next session was a more formal "conference type" presentation
by Sandy Bradbrook, Chief Exec Birmingham
Children's Hospital in the Confidentiality and Consent section, on the
new consent forms and procedures
which have been introduced to the NHS. He gave a trust eye view on the
introduction process and lack of financial support, despite initial evidence
showing it takes 6 to 16 minutes longer to complete per patient and potential
conflicts with coordinated care. He did emphasise the improvements for patients
and relatives of the improvements in the process of gaining consent for
procedures and the importance of this in the light of legal changes including
the Human Rights Act 1998. he stressed the importance of risk management in
this context and concluded that "the protection of patients comes at a
cost".

The next speaker was Phil Walker, Head of Information Governance at the
DoH Information Policy Unit, and also
working with the NHSIA. He considered various aspects of
Consent relating to patient
information and in particular
Gaining patient
consent to disclosure . He discussed a balance between society (scientific)
benefits of information sharing and individual rights and autonomy. He stressed
a principle of patient choice, but highlighted the potential difficulties when
this is exercised. Recent consultation has led/is leading to a code of practice
for staff, improving communications about these issues with the public and
guidance on implementation including temporary support for the changes
introduced in Section 60 of the
Health
and Social Care Act 2001. He promised "Big Things" on information
governance coming soon.

The final event was a panel discussion with Alistair Liddell, Peter
Drury, Nick Manson - chaired by Richard Gibbs.

A series of questions relating to Informatics developments in the NHS had been
answered by delegates on-line before the events and the panel were asked to
make a few comments on these and then respond to questions and comments from
the floor.

Nick commented on the tension between the "push" of national projects
against the "pull" of service developments. He speculated that
political pressure will deliver the IT programme via pus but that there is a
need to develop the pull by enhancing the benefits from IT systems.

Peter suggested that local delivery plans need to ensure integration into
everyday practice, particularly in relation to the Integrated Care Records
System (ICRS) building on work from EPR, EHR & ERDIP. He also discussed the
issues surrounding short termism (from trust chief execs) against the longer
term investment needed for IT systems and the potential disconnection of NSFs
from the IT agenda.

Alistair focused on the need for leadership in NHS IT developments and the need
to shorten timescales before developments happen (possibly by breaking them
into bitesize chunks and being prepared to take risks & be opportunistic).
He also announced that the NHSU development plan and consultation would be
unveiled tomorrow see: http://www.nhsu.nhs.uk

The final discussion again touched on the balance between big central
initiative and local projects and included suggestions for all nurses to be
given lap top for use at home, and ring fencing of IT money.
Final reminders of the importance of this topic to NHS Plan, NHS Modernisation
were given with exhortations for all Strategic Health Authorities to achieve
full ICRS functionality by the target date of 2008 and the coherence with the
whole NHS agenda.